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氩激光光凝治疗儿童疑似寄生虫引起的前葡萄膜炎肉芽肿。

Argon laser photocoagulation for treatment of presumed trematode-induced granulomatous anterior uveitis in children.

机构信息

Department of Ophthalmology, Faculty of Medicine, Sohag University, Sohag, Egypt.

Department of Ophthalmology, Faculty of Medicine, Assiut University, Assiut, Egypt.

出版信息

Br J Ophthalmol. 2022 Dec;106(12):1667-1671. doi: 10.1136/bjophthalmol-2021-318796. Epub 2021 Jun 18.

Abstract

BACKGROUND/AIMS: To assess the safety and efficacy of argon laser photocoagulation as a new modality for the treatment of presumed trematode-induced granulomatous anterior uveitis (PTGAU) in children.

METHODS

Forty-eight eyes of 48 children with PTGAU with pearl-like nodule(s) in the anterior chamber were included in this prospective non-randomised controlled clinical trial. The patients were divided into two groups: those in Group A (23 eyes) were treated with one session of argon laser applied to the anterior chamber nodules and those in Group B (25 eyes) received medical treatment in the form of topical steroid and cycloplegic eye drops with trans-septal triamcinolone injections. All cases were followed up for 3 months with measurement of visual acuity (VA), assessment of the anterior chamber reaction and measurement of the pearl-like nodule size.

RESULTS

In Group A, 22 eyes (95.65%) showed regression of the pearl-like nodules with resolution of the anterior chamber reaction (flare and cells) and improvement in visual acuity from 0.52±0.12 to 0.06±0.08 logMAR (p<0.001). Such improvement was maintained within the 3-month follow-up period. In Group B, 23 eyes (92%) showed initial regression of the granulomas, which was maintained in only 14 eyes (56%),with nine eyes experiencing recurrence after 3 months of follow-up.

CONCLUSION

Argon laser photocoagulation is a safe and effective novel treatment for PTGAU with pearl-like nodules in the anterior chamber in children. Larger studies with longer follow-up periods are needed to confirm these results.

摘要

背景/目的:评估氩激光光凝作为一种治疗儿童疑似吸虫诱导的前葡萄膜炎(PTGAU)的新方法的安全性和疗效。

方法

本前瞻性非随机对照临床试验纳入了 48 例儿童 PTGAU 患者,其前房有珍珠样结节。将患者分为两组:A 组(23 只眼)行氩激光光凝前房结节治疗,B 组(25 只眼)行皮质类固醇和睫状肌麻痹滴眼剂联合经筛板曲安奈德注射治疗。所有患者均随访 3 个月,测量视力(VA)、前房反应评估和珍珠样结节大小。

结果

A 组 22 只眼(95.65%)的珍珠样结节消退,前房反应(闪光和细胞)消失,视力从 0.52±0.12 提高至 0.06±0.08 logMAR(p<0.001)。在 3 个月的随访期内,视力保持稳定。B 组 23 只眼(92%)的肉芽肿最初消退,但仅 14 只眼(56%)持续消退,9 只眼在随访 3 个月后复发。

结论

氩激光光凝是一种安全有效的治疗儿童前房珍珠样结节性 PTGAU 的新方法。需要进行更大规模、更长时间随访的研究来证实这些结果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cf04/9685699/e52e346d6bcb/bjophthalmol-2021-318796f01.jpg

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